Hale Goksever Celik, MD

Dr. Goksever Celik is an obstetrician and gynecologist, graduated from the medical school of the Hacettepe University in Ankara, and trained through Obstetrics and Gynecology fellowship at Dokuz Eylul University in Izmir. She has been a postdoctoral research fellow at Molecular Biology and Genetics at Istanbul University. She has been participating in several research especially interested in the association between endometriosis surgery and ovarian reserve and the genetic basis of endometriosis.

Postoperative pregnancy rate in infertile women with deep infiltrating endometriosis

Deep infiltrating endometriosis (DIE) is fibrous/muscular infiltration of organs and anatomical structures containing endometrial tissue below the peritoneum regardless of the depth of infiltration. Another definition describes DIE as infiltration of the peritoneum by endometriotic lesions deeper than 5 mm. Pain, subfertility/infertility are the main clinical symptoms of these patients in whom surgical removal of all endometriotic lesions is required due to better outcomes in pain and fertility relief. To investigate the impact of surgeon’s experience on postoperative spontaneous pregnancy rate,…

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Implantation failure in endometriosis patients - Jovana Lekovich, MD., PhD.

Endometriosis is one of the leading reasons for infertility due to decreased oocyte/embryo quality, fertilization ability, tubal function, and aberrant endometrial receptivity. Whether this failure is caused by oocyte/embryo or eutopic endometrium is one of the investigated topics in endometriosis research. Although previous studies claimed that abnormal oocyte/embryo development results in infertility in endometriosis patients, it is known that the endometrium has an important role in the clinical pregnancy rate and live birth rate based on recent publications. When eutopic…

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In vitro fertilization protocols in endometriosis patients - Pinar Kodaman, MD., PhD.

Infertility is frequently encountered in endometriosis patients because of anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis, and sperm movements. Even though the disease stage and presence of endometrioma is negatively correlated with infertility, it is unpredictable which women are at higher risk for this problem. Endometriosis fertility index (EFI) considering female age, years of infertility, prior pregnancy status, least function score, and American Fertility Society score can be used for this aim, and higher EFI score is associated…

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Endometrioma size and anti-Müllerian hormone levels

Endometriotic lesions are encountered in different locations in the pelvic cavity, including but not limited to the ovaries, the pouch of Douglas, the ureters, the bladder, and the bowel. Cystic endometriosis lesions located in the ovary are called "endometrioma". Endometriomas have the risk of impairing ovarian reserve, which defines the capacity of the ovaries. One of the reliable independent markers of ovarian reserve is the anti-Müllerian hormone that is produced by preantral and small antral follicles. Knowing the level of preoperative…

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Reduced risk of "small for gestational age baby" following frozen embryo transfer in endometriosis patients

Infertility is encountered frequently in patients with endometriosis. These women could be managed using assisted reproductive technology (ART) including in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) to achieve pregnancy. However, some adverse obstetric and perinatal outcomes are experienced more commonly in these pregnancies due to the intrinsic and/or extrinsic characteristics of the patients. Ovarian stimulation protocols, laboratory techniques, type of embryo transfer, altered implantation and subsequent placental function, local disturbances during the embryo transfer, hormonal stimulation on the endometrium,…

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Segmental bowel resection could be predicted using MRI in patients with rectal endometriosis

The rectum and recto-sigmoid junction are the preferential localisations of bowel endometriosis. The three main surgical approaches are shaving, disc excision, and segmental resection. It is very important to decide the most appropriate surgical method preoperatively and to plan accordingly.  Currently, there is no international consensus on the surgical approach for lesions involving the rectum and recto-sigmoid junction, however, a superficial infiltration is generally managed by rectal shaving but, for deeper or larger infiltrations, the radical segmental resection approach with…

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Psychometric properties of Endometriosis Health survey-Swedish version

Endometriosis is a chronic estrogen-dependent disease resulting in a broad spectrum of symptoms and signs including dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Additionally, gastrointestinal and urinary systems may be affected by this disease. All of these clinical findings impair health-related quality of life which is difficult to define. Several generic surveys have been used to understand the physical, mental, social, and psychosexual well-being of these patients. However, none could measure the degree of the quality of life accurately due…

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Depression and anxiety levels in "in vitro fertilization" patients with endometriosis

Endometriosis is a reproductive-aged and estrogen-dependent disease. The most common symptoms of this disease are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility affecting the quality of life in several aspects mainly the psychological domain. In the literature, there are many studies reporting higher levels of depression and anxiety in these women. Medications in the treatment of endometriosis, some familial risk factors, and the underlying mechanisms of endometriosis including neuroinflammation, autoimmunity dysregulation may contribute the mood changes in the patients with endometriosis. Ceran…

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Sleep Quality, Lifestyle Factors and Endometriosis

Endometriosis does not only affect the patients by dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. An important issue in these patients, like other chronic diseases, is sleep quality. Youseflu et al., from Iran, published a study entitled “Effects of endometriosis on sleep quality of women: does lifestyle factor make a difference?” in the journal "BMC Women’s Health". The authors aimed to assess the impact of lifestyle factors such as physical activity levels, diet, body mass index, cigarette smoking on the…

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The impact of laser vaporization on reproductive outcomes in women with endometrioma

Despite extensive research, the optimal method for the management of endometriosis still remains unclear. Excisional surgery is claimed with a more favorable outcome than drainage and ablation regarding the recurrence of disease and symptoms. On the other hand, cyst vaporization with CO2 fiber laser which aims to destroy endometriotic epithelium surrounded by stroma lining the cyst is a viable alternative comparing to ovarian cystectomy in terms of endometrioma recurrence, and pain symptoms. CO2 laser vaporization is simple and easy to…

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Patient-centered care in patients with endometriosis

The women with endometriosis suffer from several symptoms and signs including dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility which have a detrimental effect on their quality of life. Endometriosis is diagnosed with 7-10 years of delay due to the absence of non-invasive diagnostic markers resulting in frequent consultations with the clinicians. Because of the high anxiety and depression scales in these women, the patient-centered endometriosis care is important, and usually the preferred approach. Schreurs et al., two groups of scientists from…

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Early maternal separation and endometriosis progression in adult mice

The quality of life in the women affected by endometriosis depends on the symptoms and signs of endometriosis such as dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Although several studies have been performed to investigate the underlying pathophysiologic mechanism, it is still poorly understood. Early-life adversity including abuse, neglect, loss of a parent, and traumatic events has been found to be associated with the development and progression of endometriosis. Preterm birth, formula feeding, intrauterine exposure to diethylstilbesterol, and childhood physical…

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The impact of obesity on safety and feasibility of laparoscopic endometriosis surgery

The quality of life in the women affected by endometriosis depends on the symptoms and signs of endometriosis such as dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. The most common locations of endometriosis are ovary, ovarian fossa, uterosacral ligament, and posterior cul-de-sac. Although some endometriosis-associated symptoms may be managed using medical treatments, surgical management remains the golden standard of diagnosis and the treatment algorithm.  The laparoscopic surgical route is accepted as the best approach by technological developments and improved surgical…

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Adolescent dysmenorrhea diagnosis and management

Endometriosis is usually diagnosed in reproductive-aged women. However, recent literature proved that clinical symptoms of endometriosis are also seen the adolescent girls and young women. Dysmenorrhea, the most common gynecologic complaint among this age group, can develop due to endometriosis. It is important to differentiate primary dysmenorrhea and secondary dysmenorrhea in this period. Dr.Hewitt from Ohio published a review entitled “Dysmenorrhea and Endometriosis: Diagnosis and Management in Adolescents” in the journal "Clinical Obstetrics and Gynecology". The author aimed to evaluate…

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The effect of endometriosis on the quality of life

Endometriosis, the disease defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity, can be diagnosed in the reproductive-aged women with an incidence of 7-15%. However, endometriosis is observed in women with chronic pelvic pain syndrome and in infertile women much more frequently. The main clinical finding of endometriosis is severe pain located in the lower abdomen during menstruation, sexual intercourse, urination, defecation, and gynecological examination. The daily routine of these women such as going to…

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Endometriosis by Race

Endometriosis is usually diagnosed in reproductive-aged women with an incidence of approximately 10%. The most common presenting symptoms are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility in patients with endometriosis. Some risk factors have been identified for the development of endometriosis. Unopposed estrogen exposure, early menarche, short menstrual cycles, long duration of menstrual flow, delayed childbearing, family history of endometriosis, and the white race are suggested to be associated with a higher risk of developing endometriosis. The basis of the…

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The predictors for sexual dysfunction in infertile women with endometriosis

Endometriosis is a disease defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity. Its incidence ranges up to 10% of reproductive-aged women. The most common symptoms in these women are chronic pelvic pain, dyspareunia, and infertility.  Endometriosis patients also suffer from psychological distress, anxiety, and depression. All of these symptoms impair the quality of life and sexual function of these patients. Youseflu et al., from Iran, published a cross-sectional study titled “Influential factors on sexual…

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Postmenopausal endometriosis: Is it a rare phenomenon?

Endometriosis, the estrogen-dependent disease defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity, is generally diagnosed in the reproductive-aged women. However, recent literature proved that this disease can also be observed in the premenopausal and postmenopausal periods. Secosan et al, scientists from Romania and France, published a review titled “Endometriosis in Menopause—Renewed Attention on a Controversial Disease” in the journal named "Diagnostics". The authors aimed to evaluate postmenopausal endometriosis in all aspects, including the prevalence,…

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Maternal body mass index and neonatal outcomes in women with endometriosis

Endometriosis is defined as the localization of endometrial glandular and stromal-like tissue outside the uterine cavity. Its prevalence is 10-15% in the general population of this age. However, endometriosis is diagnosed more frequently in infertile women with a prevalence of 25-40%.  Infertility in women with endometriosis is managed most commonly by assisted reproductive technology (ART) modalities. The recent literature provides controversial data about the obstetric outcomes of in vitro fertilization treatments in patients with endometriosis. The increased risk of preterm…

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Recurrence following surgery for subtypes of endometriosis

Endometriosis is a disease identified by the location of endometrial stromal and glandular cells outside the uterine cavity. It is considered as a gynecological disease of reproductive-aged women. Three subtypes of endometriosis are peritoneal endometriosis which defines the endometriotic lesions located on the peritoneal surface, ovarian endometrioma which are the cysts with chocolate-like content located in the ovaries, and deep infiltrating endometriosis which defines the endometriotic lesions situated more than 5 mm deep to the peritoneum. There are several treatment…

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